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- PUBLIC WORKS PERMIT Date 5l1112011 <br /> �,�� "' Public Works Permit # PW1105-005 <br /> Ciry oi Everett Public Works Department <br /> � 3200 Cedar Street Building Permit #; PW0909-020 <br /> � - �.,��; �,.,;,�;7,'' <br /> Everett, w� 9e2ot Pianning Reference#. <br /> (425) 257-8810 <br /> Public Works Fee�: S 25.00 <br /> Other S. <br /> OWNER NAME AND AG�'�2ESS: APPLICANT NAME AND ADDRESS: <br /> FIKKERT SETH 8 LAUREN <br /> 1932 ROCKEFEL![R AVE <br /> EVERETT VVA 98201 <br /> PHONE: 4257709069 PHONE: <br /> TAX PARCEL ID# 00437038001701 SITE ADDRESS: 1932 ROCKEFC-�L[R AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> REPLACE/REPAIR RETAINING WA�_L 8 REMOV[ CCNCRET[ <br /> �FRMIT CONDITIONS <br /> 1 All calls for mspection shall be made 24 hours in advance <br /> 2 All work shav � � performed in accordance wlth the permit and ciurent C.:; of Everett Design and Construction C�3r,dards <br /> and Specific.. ,ns <br /> 3 Call Location U�derground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4 No dirt, mud, rocks or debris to be lracked onto roade:ay <br /> 5. No buddmg matenais to be stached on roadway and readway �o be kept clean and open for pedeslrian travel � <br /> 6. If damaged, the broken or damaged sidewalk, curb & autter wlll need to be replaced per City of Everett � <br /> S[andard Plan #'s 305A 8 306 ,.., <br /> � <br /> Call inspec;�r Randy Allen at d25-339-7403 for inspeclion and/or consultation ,� <br /> -819/1 t�- Permit amended to add fe�ce to top_ol retaminy wall-See revised sde plan_:� 0 <br /> �----- - ---- — - <br /> � <br /> 0 <br /> � <br /> � <br /> '� <br /> ACKNOYVL[DG[�vi[NT OF CONDITIONS <br /> ' � Thc undersigned owned.pplicaN hcreby agrecs lo hold and <br /> save harmle55 ihe City ol Eveietl Irom any and all clalms (or <br /> damages, costs. expenses, or causes o(action Ihal may anse <br /> because of ms�allation and maintenance o(Uie improvement <br /> or other nght-of-way use here�o applied for and fur7her agree:: <br /> lo remove sa e upon notice from the Cdy and to replace <br /> Appto e 0� n5ln h�l DBIe pubtic prope y damaged ihereby. <br /> _� 2_ ��;-- ' �-- <br /> r NAL INSPE ION Date � � <br /> Approved as Conslructed Signature Applicant Da e <br /> WORK l+UTHONIZED BY TNIS PFRh1ff D1U5T 5E SLIRTED WIT}11N 18D DAYS OP DATE PERh1R ISSUED AND 1 HERFAFTER 15 TO HE DIIIGENTIY <br /> PUR_UFD TO C01•iPLE110N. THIS PERhI(T D1AY O[UNCELIEU BY THE CffY UPON ANY STOPP GE OF WORK ON THIS PRO)ECT OVER 9�DAYy UUfiAT10�J. <br />